Provider Demographics
NPI:1396013157
Name:BRAYMAN, EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:BRAYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65-11 BOOTH STREET
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4184
Mailing Address - Country:US
Mailing Address - Phone:718-806-1434
Mailing Address - Fax:718-806-1435
Practice Address - Street 1:210-08 NORTHERN BOULEVARD
Practice Address - Street 2:SUITE 1A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3211
Practice Address - Country:US
Practice Address - Phone:718-806-1434
Practice Address - Fax:718-806-1435
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine